Live from the GI Conference: Obese or Average?

When is a child's weight average and when is it considered to be in the worrisome range or "obese"? Two interesting studies presented at the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition this week caught my attention since there is a relationship between obesity and the severity of Gastroesophageal Reflux Disease (GERD) symptoms.

The first study was a web based survey of pediatricians. They were asked to estimate their own weight and the weight of their children. The vast majority of pediatricians who responded to the survey were able to estimate their own weight accurately (84%). It was surprising to find that only 55% of the pediatricians correctly identified the weight of their own children. Since pediatricians are on the front lines of assessing children during well check ups, it is essential that they fine tune their awareness to accurately estimate the weight of children. Pediatricians hold a great deal of influence and they can counsel parents and children about worrisome weight issues.

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The second study looked at parent's perceptions of their child's current weight. Parents were asked to rate their child's weight as underweight, average or overweight. The researchers compared the child's actual weight to the parent's perception. It was found that children of average weight were considered average by their parents (88 out of 100). It is interesting to note that many of these parents were also concerned about future risk for obesity. Children with a weight in the overweight range were rated as "average" (79 out of 100) by the majority of their parents. Further, only 68 out of 100 of the parents with children in the overweight age were concerned about the future obesity risk of their children.

Both studies show the importance of our perceptions in shaping our ideas. Both parents and physicians need to use accurate measures such as growth charts to look at weight trends over time. The charts really do tell the story-they indicate the height, weight and head size of a child in comparison to other children of the same age. While it is important to see a steady rate of growth over time, if there is a steady trend toward the high end of normal or obese, physicians and parents need to work together to address the issue as soon as possible.

Under the umbrella of "lifestyle treatments" for acid reflux, children and adults are advised to maintain an average weight or lose weight (if overweight) as a tool to manage reflux. Managing weight is a low cost, non medication approach to treating reflux that all children and adults with reflux can benefit from.